Targeted Radiation Therapy Offers Options for Breast Cancer Treatment

Getting Back to Normal Life Sooner Following Breast Cancer

Kristy Gerry has a hard time believing she had breast cancer and it has only been six months since her treatment.

“I just had a follow up appointment with the doctor and I told him, `I feel like nothing happened,’” said Gerry. “Sometimes it’s hard to remember how serious it was.”

Gerry, 54, credits her quick recovery to skilled doctors and nurses at The Nebraska Medical Center and a breast cancer radiation therapy called MammoSite.

MammoSite therapy was developed to make it easier for more women to consider lumpectomy or breast conservation. Despite comparable long-term recurrence and survival rates of breast conservation therapy, the National Institutes of Health reports more than 40 percent of patients with early stage breast cancer still get a mastectomy.

“People are being sold on the idea that removing the whole breast is better than removing the cancerous lump and using radiation therapy,” said Edibaldo Silva, M.D., PhD. surgical oncologist at The Nebraska Medical Center. “We know that is not true; and that’s based on 40 years of clinical research and thousands and thousands of patients.”

Dr. Silva says many women often choose a mastectomy because the conventional radiation therapy after a lumpectomy includes daily treatments for six to seven weeks and can be a burden with long daily commutes and unwanted side effects. That’s why he says the MammoSite 5-day targeted radiation therapy is such a great alternative.

“The real advantage is that you can finish treatment in just five days, and spare the breast,” said Dr. Silva.

MammoSite therapy delivers targeted radiation therapy directly to the area where cancer is most likely to recur, allowing a full course of radiation to be delivered in just five days.

“After removing the breast cancer tumor, a MammoSite balloon catheter is placed inside the tumor cavity through a small incision in the breast,” explained Andrew Wahl, MD, radiation oncologist at The Nebraska Medical Center. “The balloon catheter remains in the breast during the 5-day treatment. During treatment, the portion of the catheter that remains outside the breast is connected to a computer-controlled machine that inserts the radiation ‘seed’ to deliver the therapy.”

“Some patients have concerns about radiation,” said Dr. Silva. “The MammoSite targeted therapy only radiates an area two centimeters in diameter around where the breast tumor was located.”

Gerry, who completed the MammoSite therapy in May, said a tremendous benefit to her was the convenience.

“It was only one week of my life,” she said. “I didn’t even take time off work for the radiation treatment. It took all of eight minutes twice a day.”

“MammoSite patients receive ten treatments; two each day for five days,” explained Dr. Wahl. “In a rural state like Nebraska where commutes are long, it’s a great option for a patient to receive treatment for only five days versus six to seven weeks.”

Additionally, the MammoSite targeted therapy of the breast limits radiation exposure to normal, healthy tissue. This helps minimize side effects such as skin discoloration, scarring and burning.

“Unlike the long-term traditional radiation therapy, we generally see less significant skin changes with the MammoSite therapy,” said Dr. Wahl.

Mammosite is not for every patient. It is not recommended yet for younger women or women with larger tumors.

“We recommend it to all women who are post-menopausal, whose tumors are less than two centimeters in size, or who have a pre-malignant condition called ductal carcinoma in situ.” said Dr. Silva.

What to Expect with MammoSite® 5-Day Targeted Radiation Therapy

An uninflated MammoSite balloon catheter is gently placed inside the lumpectomy cavity through a small incision in the breast

The balloon is ‘inflated’ with saline solution so that it fits snugly into the cavity. It remains inflated during the 5-day treatment

A small portion of the catheter remains outside the breast; this is secured to a cushioned gauze pad to prevent movement of the catheter

Treatment

During therapy, patients visit the radiation oncologist twice a day for 5 days. Each treatment takes about 30 minutes

During treatment, the portion of the catheter that remains outside the breast is connected to a computer-controlled machine that inserts the radiation “seed” to deliver the therapy; once therapy is complete, the seed is removed, the catheter is unplugged, and patients are free to return to their normal daily activities

No radiation remains in the breast in between treatments

Removal

After 5 days of treatment, the MammoSite balloon catheter will be removed, usually on the last day of treatment

The balloon is gently removed through the same incision made to place it. The incision is then closed with a small bandage

Most women feel little or no discomfort either during insertion or during removal

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